<form id="edit-form" class="form-horizontal" role="form" data-toggle="validator" method="POST" action="">

    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Receiving')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-receiving_text" class="form-control" type="text" value="{$row.receiving_text|htmlentities}" readonly>
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Come')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-come_text" class="form-control" type="text" value="{$row.come_text|htmlentities}" readonly>
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Service')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-service_text" class="form-control" type="text" value="{$row.service_text|htmlentities}" readonly>
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Evaluate')}:</label>
        <div class="col-xs-12 col-sm-8">
            <textarea class="form-control" rows="5" style="resize: none;" readonly>{$row.evaluate|htmlentities}</textarea>
        </div>
    </div>
</form>
